Cardiometabolic and Psychobehavioral Phenotypes Define Cardiovascular Risk Heterogeneity in Rheumatoid Arthritis

The study analyzed 3,252 adults with rheumatoid arthritis from the American National Health and Nutrition Examination Survey (NHANES) from 2005-2018. Using statistical analysis, six distinct phenotypes with varying cardiovascular risk were identified: Severe Metabolic Diabetic (40.3% cardiovascular disease prevalence), Aging Diabetic Hypertensive (34.9%), Non-Diabetic Intermediate (20.2%), Mild Metabolic (14.8%), Cardiometabolic (10.4%), and Smoking-Predominant (19.4%). The Severe Metabolic Diabetic phenotype had 4.11 times higher odds of cardiovascular disease compared to the Cardiometabolic phenotype. The results demonstrate that different combinations of metabolic, inflammatory, renal, behavioral, and psychosocial factors create distinct risk profiles in patients with rheumatoid arthritis.